Recanalization of coronary occlusions using the Magnarail system: technique and procedural outcome

Angioplasty for occluded coronary arteries is less successful than for sub-total stenoses. The Magnarail system (Schneider) has been designed to improve success rates. We used the system in 112 patients with coronary occlusions (TIMI flow < or = 1) which the operator felt suitable for angioplasty. It was successful (defined as < 50% stenosis) in 75.9% overall, 65.9% in occlusions > 3 months and 83.3% < 3 months. Intimal dissection occurred in 26 instances, more commonly after right coronary angioplasties. One patient died and one procedure was complicated by coronary perforation treated surgically. The procedure was less successful in the right coronary artery (p = 0.02). Coronary calcification (p = 0.03), the absence of a tapered occlusion (p = 0.04) and the absence of collaterals from another vascular territory (p = 0.04) were all associated with angiographic failure. The mean fluoroscopy time for the procedures was 22.8 +/- 16.9 minutes. The Magnarail system seems highly effective in recanalization of coronary occlusions.